Preparations for vaccination against Covid 19 are nearing completion. It is only natural that people who have been suffering from severe mental stress, death of near ones, unemployment etc. for several months will be interested in getting vaccinated. For good reason, everyone from health workers to the general people is eager to know the details. We feel, as a medical organizasaton, it is our responsibility to provide accurate information about vaccination. Everyone should be vaccinated to control this epidemic. However, we are demanding transparency from the government on a number of issues.
Covishield vs. Covaxin
Two vaccines have received official approval in India at this moment. The first is the ‘Covishield’, researched by the University of Oxford and developed at the Serum Institute of India. The second is ‘Covaxin’, researched by ICMR and developed by Bharat Biotech.
Covishield is actually a vaccine made from a live virus carrier similar to the AZD1222 vaccine from Oxford University and the Astra-Geneca Institute. The vaccine is made by inserting the corona virus spike protein gene into an adenovirus that infect chimpanzees. The virus cannot replicate itself in human body. The vaccine will penetrate the muscle cells in the upper arm where the vaccine will be injected and will create spike proteins in human muscle. Antibodies and memory cells are made in the body against those spike proteins to give immunity. The official document on the Covishield states tabout its ‘restricted use in emergency situation in public interest in an abundant precaution…’
Bharat Biotech’s Covaccine is a vaccine made from dead SARS-Cov 2 virus. This dead virus cannot reppicate in in human body. Antibodies and memorycells are made against spike protein of the dead virus. It should be noted that in case of the second vaccine, the government has announced that the vaccine will be given in ‘clinical trial mode’.
Dosage and schedule
In the case of Covishield, for the time being, two doses of intramasclar injection in the arm at an intervals of four weeks.In case of Covaxin, two doses should be given by sub cutaneous injection. Because there is no certainty about how long the vaccine will last, the vaccines may need to be taken again every year. However, nothing absolute can be said at this moment.
All vacccines have side effects. In the limited experience, no major problems have been found in both Covishield and Covaxin – according to the pharmaceutical companies concerned. However, in the case of mass immunisation, the government should make a very effective and efficient measure for response and cure of side effects, if any. If there is any new or strange sensation in the body within a few weeks of vaccination, the concerned department should be contacted immediately.
The manufacturer claims that Covishield is about 70% effective in preventing disease. In the case of Covaxin, we have not yet received evidence of its effectiveness. It is unknown till now for how many days these vaccines will give us protection. However, it is expected that effective protection will be maintained for at least 9 months to 1 year. No vaccine can give you one hundred percent protection. Therefore, even after getting vaccinated, use face mask regularly, maintain physical distancing rules and keep your hands germ-free.
Those who have been infected once
Experts believe that post infection natural immunity is not very reliable. So in all these cases the vaccine should be taken. Viral diseases like measles or chicken poxdoes not give us long term immunity.
If you have recently been vaccinated against any other disease
Covaccine is made from a dead virus. And the viruses of Covishield can not replicate in human being. So there is no contraindication of covid vaccination with other vaccines.
New mutant virus
Of the two special mutant viruses we know of so far, the N501Y mutant found in England can probably be controlled by vaccines. Plasma therapy has not been able to completely inactivate the E 484 K mutantvirus from South Africa. In that case, the effectiveness of the vaccine may be slightly lower. But none of this has any evidenceyet.
Pregnancy and lactation
We do not have any scientific evidence that taking the two recognized vaccines in India will not cause any problems during pregnancy or breastfeeding. According to traditional vaccine science, vaccines made from dead viruses are usually safe for pregnant mothers. In that case, covaxin may be safer than Covishield. However, these vaccines should not be used on pregnant and breastfeeding mothers until adequate evidence is available.
Do you have a choice?
At the moment, only two vaccines have been cleared in India. So there is no options outside that. However, we do not know if you will have the right to choose between the two recognized vaccines. It is unknown at this time whether more vaccines (such as Pfizer or Moderna) will be available in the country through private or non-government initiatives.
Demands of Joint Platform of Doctors, West Bengal
Let everyone know these issues:
A) Will the vaccine prevent the disease or reduce the severity of the disease?
B) At what stage of clinical trial do these vaccines belong?
C) What is the effectiveness of vaccines according to different age groups?
Let the basic human rights be respected:
A) In accordance with the recognized international rules, the vaccine should be given only after written, informed consent of the recipient.
B) At this stage no one can be forced to take the vaccine in any way.
C) If someone is not able to participate in the first immunization program, they should get the opportunity later.
D) In case of any side effects after vaccination, the state should provide all the necessary treatment.
E) In case of any permanent loss to the recipient as a result of vaccination, the Government is responsible for the appropriate compensation of the recipient.
We want a neutral surveillance system.
Vaccination should be carried out under the supervision of one or more recognized international organizations by recruiting volunteers. They will register:
A) Whether the vaccine is being given subject to consent as per proper rules?
B) Are there any emergency measures to deal with the side effects at the place where the vaccine is being given?
C) Whether each side effect is being documented in detail and how they are being handled?
D) There shall be no political or state pressure or directive in collecting information regarding above mentioned matters. If the government wishes observers will share collected information, but they will submit the information to a recognized international organization.
E) All immunization information will be available to the public in real time online.
The responsibility of the government
It is the responsibility of the central government to provide vaccinations to all the people of the country and to bear all the expenses. If the central government fails to do so, state government will have to take this responsibility.
Respected President, respected Vice President, respected Prime Minister, all the ministers, MPs and MLAs of the Central and State Governments should be vaccinated publicly to ward off fear, inertia, reluctance or suspicion of vaccination among common people.
Dr. Hiralal Kongar and Dr. Punyabrata Gun,
Joint Convenors of the Joint Platform of Doctors, West Bengal
(Association of Health Service Doctors, West Bengal, West Bengal Doctors Forum, Shramajibi Swasthya Udyog,
Health Service Association, Doctors for Democracy)
January 13, 2021.